Nephrotic Syndrome And Nursing Care

Nephrotic Syndrome
Is a type of kidney condition that are distinguished by the presence of massive edema, heavy albuminuria,hypoalbuminemia,and hyper-cholesterolemia.Usualy affects male more than female between 1-5 years age group.Clinical feature:
– massive edema :noticed at first around the eyes and ankles but later become
generalized(ascitis ,scrotal edema ,and pleural effusion).– Diagnosis:
– history ,clinical feature and investigation which include:
– GUE→heavy albuminuria + + + or + + + +
– serum albumin decrease.
– serum cholesterol increase.Treatment:
prednisolone is given when the condition is first recognized and has proved valuable.Diuretics has not generally been effective in reducing nephrotic edema.Immunosuppressive therapy e.g :- cytoxan ,chlorambucil ,cyclophosphamide has shown promise for some steroid resistant children.Nursing care:1- Do chart of renal disease (weight, blood urea, urine out put).2- Care of the skin : the skin is bathed daily and whenever necessary. Special
attention is given to the neck, under arms, groin and other moist area of the
body. The male genitalia are bathed and dusted with a soothing powder .When
necessary the scrotum is supported with a soft pad. Never use adhesive because
it lead to scratching and infection .3 -Position :

The patient is turned frequently to prevent respiratory infection, the child’s
head is elevated from time to time during day to reduce edema of eye lids, it may be necessary to bath the eyes to prevent the accumulation of the exudates.4- Always keep him away from patient with infection.5- Diet should be high in protein. The fluid intake of the child is recorded following each meal.Itis important to keep proper fluid balance sheets (intake and output records).6- Urine: The patient’s urine must be carefully measured and the nurse must know how to test the urine for albumin using special reagent strips.7-Body weight :The patient is weighed daily to determine changes in the degree of edema.8- The nurse should explain the nature of the illness to the parents and the side
effect of the steroid therapy and how to test urine for protein.Prognosis: is favorable but depends on patient’s response during therapy.